|
Other respiratory & chest procedures
|
Facility
|
IP
|
$60,638.51
|
|
|
Service Code
|
APR-DRG 1212
|
| Min. Negotiated Rate |
$19,645.00 |
| Max. Negotiated Rate |
$60,638.51 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$60,638.51
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$60,638.51
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$26,950.45
|
| Rate for Payer: Amida Care Medicaid |
$26,950.45
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$60,638.51
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$26,950.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26,950.45
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32,340.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26,950.45
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26,950.45
|
| Rate for Payer: Healthfirst Commercial |
$31,009.00
|
| Rate for Payer: Healthfirst Essential Plan |
$60,638.51
|
| Rate for Payer: Healthfirst QHP |
$19,645.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26,950.45
|
| Rate for Payer: SOMOS Essential |
$60,638.51
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$60,638.51
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$60,638.51
|
| Rate for Payer: United Healthcare Medicaid |
$26,950.45
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$26,950.45
|
|
|
Other respiratory & chest procedures
|
Facility
|
IP
|
$138,545.68
|
|
|
Service Code
|
APR-DRG 1214
|
| Min. Negotiated Rate |
$61,575.86 |
| Max. Negotiated Rate |
$138,545.68 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$138,545.68
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$138,545.68
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$61,575.86
|
| Rate for Payer: Amida Care Medicaid |
$61,575.86
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$138,545.68
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$61,575.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$61,575.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$73,891.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$61,575.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$61,575.86
|
| Rate for Payer: Healthfirst Commercial |
$110,268.00
|
| Rate for Payer: Healthfirst Essential Plan |
$138,545.68
|
| Rate for Payer: Healthfirst QHP |
$67,564.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$61,575.86
|
| Rate for Payer: SOMOS Essential |
$138,545.68
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$138,545.68
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$138,545.68
|
| Rate for Payer: United Healthcare Medicaid |
$61,575.86
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$61,575.86
|
|
|
Other respiratory & chest procedures
|
Facility
|
IP
|
$53,274.62
|
|
|
Service Code
|
APR-DRG 1211
|
| Min. Negotiated Rate |
$14,928.00 |
| Max. Negotiated Rate |
$53,274.62 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$53,274.62
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$53,274.62
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,677.61
|
| Rate for Payer: Amida Care Medicaid |
$23,677.61
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$53,274.62
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,677.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,677.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28,413.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,677.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,677.61
|
| Rate for Payer: Healthfirst Commercial |
$23,526.00
|
| Rate for Payer: Healthfirst Essential Plan |
$53,274.62
|
| Rate for Payer: Healthfirst QHP |
$14,928.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,677.61
|
| Rate for Payer: SOMOS Essential |
$53,274.62
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$53,274.62
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$53,274.62
|
| Rate for Payer: United Healthcare Medicaid |
$23,677.61
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,677.61
|
|
|
Other respiratory diagnoses except signs, symptoms & minor diagnoses
|
Facility
|
IP
|
$45,365.56
|
|
|
Service Code
|
APR-DRG 1432
|
| Min. Negotiated Rate |
$8,399.00 |
| Max. Negotiated Rate |
$45,365.56 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$45,365.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$45,365.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$20,162.47
|
| Rate for Payer: Amida Care Medicaid |
$20,162.47
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$45,365.56
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$20,162.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,162.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,194.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20,162.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20,162.47
|
| Rate for Payer: Healthfirst Commercial |
$14,728.00
|
| Rate for Payer: Healthfirst Essential Plan |
$45,365.56
|
| Rate for Payer: Healthfirst QHP |
$8,399.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20,162.47
|
| Rate for Payer: SOMOS Essential |
$45,365.56
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$45,365.56
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$45,365.56
|
| Rate for Payer: United Healthcare Medicaid |
$20,162.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20,162.47
|
|
|
Other respiratory diagnoses except signs, symptoms & minor diagnoses
|
Facility
|
IP
|
$54,577.87
|
|
|
Service Code
|
APR-DRG 1433
|
| Min. Negotiated Rate |
$12,791.00 |
| Max. Negotiated Rate |
$54,577.87 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$54,577.87
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$54,577.87
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$24,256.83
|
| Rate for Payer: Amida Care Medicaid |
$24,256.83
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$54,577.87
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$24,256.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$24,256.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29,108.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24,256.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24,256.83
|
| Rate for Payer: Healthfirst Commercial |
$22,055.00
|
| Rate for Payer: Healthfirst Essential Plan |
$54,577.87
|
| Rate for Payer: Healthfirst QHP |
$12,791.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24,256.83
|
| Rate for Payer: SOMOS Essential |
$54,577.87
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$54,577.87
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$54,577.87
|
| Rate for Payer: United Healthcare Medicaid |
$24,256.83
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$24,256.83
|
|
|
Other respiratory diagnoses except signs, symptoms & minor diagnoses
|
Facility
|
IP
|
$68,206.39
|
|
|
Service Code
|
APR-DRG 1434
|
| Min. Negotiated Rate |
$18,391.00 |
| Max. Negotiated Rate |
$68,206.39 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$68,206.39
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$68,206.39
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$30,313.95
|
| Rate for Payer: Amida Care Medicaid |
$30,313.95
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$68,206.39
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$30,313.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30,313.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36,376.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30,313.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30,313.95
|
| Rate for Payer: Healthfirst Commercial |
$33,983.00
|
| Rate for Payer: Healthfirst Essential Plan |
$68,206.39
|
| Rate for Payer: Healthfirst QHP |
$18,391.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30,313.95
|
| Rate for Payer: SOMOS Essential |
$68,206.39
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$68,206.39
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$68,206.39
|
| Rate for Payer: United Healthcare Medicaid |
$30,313.95
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$30,313.95
|
|
|
Other respiratory diagnoses except signs, symptoms & minor diagnoses
|
Facility
|
IP
|
$41,357.36
|
|
|
Service Code
|
APR-DRG 1431
|
| Min. Negotiated Rate |
$6,249.00 |
| Max. Negotiated Rate |
$41,357.36 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$41,357.36
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$41,357.36
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,381.05
|
| Rate for Payer: Amida Care Medicaid |
$18,381.05
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$41,357.36
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,381.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,381.05
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22,057.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,381.05
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,381.05
|
| Rate for Payer: Healthfirst Commercial |
$10,352.00
|
| Rate for Payer: Healthfirst Essential Plan |
$41,357.36
|
| Rate for Payer: Healthfirst QHP |
$6,249.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,381.05
|
| Rate for Payer: SOMOS Essential |
$41,357.36
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$41,357.36
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$41,357.36
|
| Rate for Payer: United Healthcare Medicaid |
$18,381.05
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,381.05
|
|
|
OTHER RESPIRATORY SYSTEM DIAGNOSES
|
Facility
|
OP
|
$246.33
|
|
|
Service Code
|
EAPG 00576
|
| Min. Negotiated Rate |
$178.20 |
| Max. Negotiated Rate |
$246.33 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$178.20
|
| Rate for Payer: Healthfirst Commercial |
$246.33
|
|
|
Other significant hip and femur surgery
|
Facility
|
IP
|
$133,058.41
|
|
|
Service Code
|
APR-DRG 3094
|
| Min. Negotiated Rate |
$59,137.07 |
| Max. Negotiated Rate |
$133,058.41 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$133,058.41
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$133,058.41
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$59,137.07
|
| Rate for Payer: Amida Care Medicaid |
$59,137.07
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$133,058.41
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$59,137.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$59,137.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$70,964.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$59,137.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$59,137.07
|
| Rate for Payer: Healthfirst Commercial |
$98,326.00
|
| Rate for Payer: Healthfirst Essential Plan |
$133,058.41
|
| Rate for Payer: Healthfirst QHP |
$70,511.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$59,137.07
|
| Rate for Payer: SOMOS Essential |
$133,058.41
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$133,058.41
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$133,058.41
|
| Rate for Payer: United Healthcare Medicaid |
$59,137.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$59,137.07
|
|
|
Other significant hip and femur surgery
|
Facility
|
IP
|
$53,920.10
|
|
|
Service Code
|
APR-DRG 3091
|
| Min. Negotiated Rate |
$13,379.00 |
| Max. Negotiated Rate |
$53,920.10 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$53,920.10
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$53,920.10
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,964.49
|
| Rate for Payer: Amida Care Medicaid |
$23,964.49
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$53,920.10
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,964.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,964.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28,757.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,964.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,964.49
|
| Rate for Payer: Healthfirst Commercial |
$22,554.00
|
| Rate for Payer: Healthfirst Essential Plan |
$53,920.10
|
| Rate for Payer: Healthfirst QHP |
$13,379.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,964.49
|
| Rate for Payer: SOMOS Essential |
$53,920.10
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$53,920.10
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$53,920.10
|
| Rate for Payer: United Healthcare Medicaid |
$23,964.49
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,964.49
|
|
|
Other significant hip and femur surgery
|
Facility
|
IP
|
$85,164.21
|
|
|
Service Code
|
APR-DRG 3093
|
| Min. Negotiated Rate |
$34,712.00 |
| Max. Negotiated Rate |
$85,164.21 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$85,164.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$85,164.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$37,850.76
|
| Rate for Payer: Amida Care Medicaid |
$37,850.76
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$85,164.21
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$37,850.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$37,850.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$45,420.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37,850.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$37,850.76
|
| Rate for Payer: Healthfirst Commercial |
$54,858.00
|
| Rate for Payer: Healthfirst Essential Plan |
$85,164.21
|
| Rate for Payer: Healthfirst QHP |
$34,712.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$37,850.76
|
| Rate for Payer: SOMOS Essential |
$85,164.21
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$85,164.21
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$85,164.21
|
| Rate for Payer: United Healthcare Medicaid |
$37,850.76
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$37,850.76
|
|
|
Other significant hip and femur surgery
|
Facility
|
IP
|
$64,989.65
|
|
|
Service Code
|
APR-DRG 3092
|
| Min. Negotiated Rate |
$19,223.00 |
| Max. Negotiated Rate |
$64,989.65 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$64,989.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$64,989.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$28,884.29
|
| Rate for Payer: Amida Care Medicaid |
$28,884.29
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$64,989.65
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$28,884.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28,884.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34,661.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28,884.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28,884.29
|
| Rate for Payer: Healthfirst Commercial |
$32,958.00
|
| Rate for Payer: Healthfirst Essential Plan |
$64,989.65
|
| Rate for Payer: Healthfirst QHP |
$19,223.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$28,884.29
|
| Rate for Payer: SOMOS Essential |
$64,989.65
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$64,989.65
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$64,989.65
|
| Rate for Payer: United Healthcare Medicaid |
$28,884.29
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$28,884.29
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DIAGNOSES
|
Facility
|
OP
|
$208.69
|
|
|
Service Code
|
EAPG 00675
|
| Min. Negotiated Rate |
$150.43 |
| Max. Negotiated Rate |
$208.69 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$150.43
|
| Rate for Payer: Healthfirst Commercial |
$208.69
|
|
|
Other skin, subcutaneous tissue & breast disorders
|
Facility
|
IP
|
$43,550.53
|
|
|
Service Code
|
APR-DRG 3852
|
| Min. Negotiated Rate |
$6,931.00 |
| Max. Negotiated Rate |
$43,550.53 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$43,550.53
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$43,550.53
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,355.79
|
| Rate for Payer: Amida Care Medicaid |
$19,355.79
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$43,550.53
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$19,355.79
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19,355.79
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23,226.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19,355.79
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19,355.79
|
| Rate for Payer: Healthfirst Commercial |
$12,106.00
|
| Rate for Payer: Healthfirst Essential Plan |
$43,550.53
|
| Rate for Payer: Healthfirst QHP |
$6,931.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19,355.79
|
| Rate for Payer: SOMOS Essential |
$43,550.53
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$43,550.53
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$43,550.53
|
| Rate for Payer: United Healthcare Medicaid |
$19,355.79
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$19,355.79
|
|
|
Other skin, subcutaneous tissue & breast disorders
|
Facility
|
IP
|
$40,446.34
|
|
|
Service Code
|
APR-DRG 3851
|
| Min. Negotiated Rate |
$5,455.00 |
| Max. Negotiated Rate |
$40,446.34 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$40,446.34
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$40,446.34
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$17,976.15
|
| Rate for Payer: Amida Care Medicaid |
$17,976.15
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$40,446.34
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$17,976.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17,976.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21,571.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17,976.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17,976.15
|
| Rate for Payer: Healthfirst Commercial |
$9,646.00
|
| Rate for Payer: Healthfirst Essential Plan |
$40,446.34
|
| Rate for Payer: Healthfirst QHP |
$5,455.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$17,976.15
|
| Rate for Payer: SOMOS Essential |
$40,446.34
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$40,446.34
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$40,446.34
|
| Rate for Payer: United Healthcare Medicaid |
$17,976.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$17,976.15
|
|
|
Other skin, subcutaneous tissue & breast disorders
|
Facility
|
IP
|
$82,927.10
|
|
|
Service Code
|
APR-DRG 3854
|
| Min. Negotiated Rate |
$21,917.00 |
| Max. Negotiated Rate |
$82,927.10 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$82,927.10
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$82,927.10
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$36,856.49
|
| Rate for Payer: Amida Care Medicaid |
$36,856.49
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$82,927.10
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$36,856.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36,856.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$44,227.79
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36,856.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$36,856.49
|
| Rate for Payer: Healthfirst Commercial |
$37,366.00
|
| Rate for Payer: Healthfirst Essential Plan |
$82,927.10
|
| Rate for Payer: Healthfirst QHP |
$21,917.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$36,856.49
|
| Rate for Payer: SOMOS Essential |
$82,927.10
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$82,927.10
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$82,927.10
|
| Rate for Payer: United Healthcare Medicaid |
$36,856.49
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$36,856.49
|
|
|
Other skin, subcutaneous tissue & breast disorders
|
Facility
|
IP
|
$51,063.89
|
|
|
Service Code
|
APR-DRG 3853
|
| Min. Negotiated Rate |
$9,570.00 |
| Max. Negotiated Rate |
$51,063.89 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$51,063.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$51,063.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$22,695.06
|
| Rate for Payer: Amida Care Medicaid |
$22,695.06
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$51,063.89
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$22,695.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22,695.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27,234.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22,695.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22,695.06
|
| Rate for Payer: Healthfirst Commercial |
$16,966.00
|
| Rate for Payer: Healthfirst Essential Plan |
$51,063.89
|
| Rate for Payer: Healthfirst QHP |
$9,570.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$22,695.06
|
| Rate for Payer: SOMOS Essential |
$51,063.89
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$51,063.89
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$51,063.89
|
| Rate for Payer: United Healthcare Medicaid |
$22,695.06
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$22,695.06
|
|
|
Other skin, subcutaneous tissue & related procedures
|
Facility
|
IP
|
$45,550.21
|
|
|
Service Code
|
APR-DRG 3641
|
| Min. Negotiated Rate |
$8,321.00 |
| Max. Negotiated Rate |
$45,550.21 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$45,550.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$45,550.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$20,244.54
|
| Rate for Payer: Amida Care Medicaid |
$20,244.54
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$45,550.21
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$20,244.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,244.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,293.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20,244.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20,244.54
|
| Rate for Payer: Healthfirst Commercial |
$14,466.00
|
| Rate for Payer: Healthfirst Essential Plan |
$45,550.21
|
| Rate for Payer: Healthfirst QHP |
$8,321.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20,244.54
|
| Rate for Payer: SOMOS Essential |
$45,550.21
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$45,550.21
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$45,550.21
|
| Rate for Payer: United Healthcare Medicaid |
$20,244.54
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20,244.54
|
|
|
Other skin, subcutaneous tissue & related procedures
|
Facility
|
IP
|
$51,535.24
|
|
|
Service Code
|
APR-DRG 3642
|
| Min. Negotiated Rate |
$12,325.00 |
| Max. Negotiated Rate |
$51,535.24 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$51,535.24
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$51,535.24
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$22,904.55
|
| Rate for Payer: Amida Care Medicaid |
$22,904.55
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$51,535.24
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$22,904.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22,904.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27,485.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22,904.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22,904.55
|
| Rate for Payer: Healthfirst Commercial |
$20,435.00
|
| Rate for Payer: Healthfirst Essential Plan |
$51,535.24
|
| Rate for Payer: Healthfirst QHP |
$12,325.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$22,904.55
|
| Rate for Payer: SOMOS Essential |
$51,535.24
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$51,535.24
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$51,535.24
|
| Rate for Payer: United Healthcare Medicaid |
$22,904.55
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$22,904.55
|
|
|
Other skin, subcutaneous tissue & related procedures
|
Facility
|
IP
|
$67,597.85
|
|
|
Service Code
|
APR-DRG 3643
|
| Min. Negotiated Rate |
$21,928.00 |
| Max. Negotiated Rate |
$67,597.85 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$67,597.85
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$67,597.85
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$30,043.49
|
| Rate for Payer: Amida Care Medicaid |
$30,043.49
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$67,597.85
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$30,043.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30,043.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36,052.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30,043.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30,043.49
|
| Rate for Payer: Healthfirst Commercial |
$37,104.00
|
| Rate for Payer: Healthfirst Essential Plan |
$67,597.85
|
| Rate for Payer: Healthfirst QHP |
$21,928.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30,043.49
|
| Rate for Payer: SOMOS Essential |
$67,597.85
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$67,597.85
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$67,597.85
|
| Rate for Payer: United Healthcare Medicaid |
$30,043.49
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$30,043.49
|
|
|
Other skin, subcutaneous tissue & related procedures
|
Facility
|
IP
|
$125,393.78
|
|
|
Service Code
|
APR-DRG 3644
|
| Min. Negotiated Rate |
$46,475.00 |
| Max. Negotiated Rate |
$125,393.78 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$125,393.78
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$125,393.78
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$55,730.57
|
| Rate for Payer: Amida Care Medicaid |
$55,730.57
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$125,393.78
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$55,730.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$55,730.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$66,876.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$55,730.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$55,730.57
|
| Rate for Payer: Healthfirst Commercial |
$74,670.00
|
| Rate for Payer: Healthfirst Essential Plan |
$125,393.78
|
| Rate for Payer: Healthfirst QHP |
$46,475.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$55,730.57
|
| Rate for Payer: SOMOS Essential |
$125,393.78
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$125,393.78
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$125,393.78
|
| Rate for Payer: United Healthcare Medicaid |
$55,730.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$55,730.57
|
|
|
Other small & large bowel procedures
|
Facility
|
IP
|
$52,715.36
|
|
|
Service Code
|
APR-DRG 2231
|
| Min. Negotiated Rate |
$13,708.00 |
| Max. Negotiated Rate |
$52,715.36 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$52,715.36
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$52,715.36
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,429.05
|
| Rate for Payer: Amida Care Medicaid |
$23,429.05
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$52,715.36
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,429.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,429.05
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28,114.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,429.05
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,429.05
|
| Rate for Payer: Healthfirst Commercial |
$22,691.00
|
| Rate for Payer: Healthfirst Essential Plan |
$52,715.36
|
| Rate for Payer: Healthfirst QHP |
$13,708.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,429.05
|
| Rate for Payer: SOMOS Essential |
$52,715.36
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$52,715.36
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$52,715.36
|
| Rate for Payer: United Healthcare Medicaid |
$23,429.05
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,429.05
|
|
|
Other small & large bowel procedures
|
Facility
|
IP
|
$59,709.89
|
|
|
Service Code
|
APR-DRG 2232
|
| Min. Negotiated Rate |
$17,653.00 |
| Max. Negotiated Rate |
$59,709.89 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$59,709.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$59,709.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$26,537.73
|
| Rate for Payer: Amida Care Medicaid |
$26,537.73
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$59,709.89
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$26,537.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26,537.73
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31,845.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26,537.73
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26,537.73
|
| Rate for Payer: Healthfirst Commercial |
$29,722.00
|
| Rate for Payer: Healthfirst Essential Plan |
$59,709.89
|
| Rate for Payer: Healthfirst QHP |
$17,653.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26,537.73
|
| Rate for Payer: SOMOS Essential |
$59,709.89
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$59,709.89
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$59,709.89
|
| Rate for Payer: United Healthcare Medicaid |
$26,537.73
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$26,537.73
|
|
|
Other small & large bowel procedures
|
Facility
|
IP
|
$78,804.59
|
|
|
Service Code
|
APR-DRG 2233
|
| Min. Negotiated Rate |
$26,916.00 |
| Max. Negotiated Rate |
$78,804.59 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$78,804.59
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$78,804.59
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$35,024.26
|
| Rate for Payer: Amida Care Medicaid |
$35,024.26
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$78,804.59
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$35,024.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$35,024.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$42,029.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$35,024.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$35,024.26
|
| Rate for Payer: Healthfirst Commercial |
$48,107.00
|
| Rate for Payer: Healthfirst Essential Plan |
$78,804.59
|
| Rate for Payer: Healthfirst QHP |
$26,916.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$35,024.26
|
| Rate for Payer: SOMOS Essential |
$78,804.59
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$78,804.59
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$78,804.59
|
| Rate for Payer: United Healthcare Medicaid |
$35,024.26
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$35,024.26
|
|
|
Other small & large bowel procedures
|
Facility
|
IP
|
$130,128.32
|
|
|
Service Code
|
APR-DRG 2234
|
| Min. Negotiated Rate |
$57,834.81 |
| Max. Negotiated Rate |
$130,128.32 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$130,128.32
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$130,128.32
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$57,834.81
|
| Rate for Payer: Amida Care Medicaid |
$57,834.81
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$130,128.32
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$57,834.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$57,834.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$69,401.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$57,834.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$57,834.81
|
| Rate for Payer: Healthfirst Commercial |
$103,966.00
|
| Rate for Payer: Healthfirst Essential Plan |
$130,128.32
|
| Rate for Payer: Healthfirst QHP |
$63,622.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$57,834.81
|
| Rate for Payer: SOMOS Essential |
$130,128.32
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$130,128.32
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$130,128.32
|
| Rate for Payer: United Healthcare Medicaid |
$57,834.81
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$57,834.81
|
|
